| NPI | 1770759342 |
|---|---|
| Former Name | MARY HELEN DIXON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D10630) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 53537) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2010-02-02 |